Hemorrhagic cyst ovary, TVS and transabdominal ultrasound, color Doppler imaging, & overview

A hemorrhagic ovarian cyst is a benign functional cyst resulting from bleeding into a follicular or corpus luteum cyst. These cysts commonly appear as complex structures with internal echoes or septations on ultrasound, caused by blood and clot formation. Color Doppler imaging typically shows no internal vascularity, helping to differentiate these cysts from other masses that might exhibit blood flow.

In this case, the cyst measures approximately 4 centimeters. The transabdominal ultrasound was inconclusive due to limited resolution, but transvaginal sonography (TVS) provided clearer details, revealing multiple thin septations and no internal vascularity. The patient was asymptomatic and tested negative for pregnancy.

Differential diagnoses include benign ovarian cysts such as serous or mucinous cystadenomas, which usually present with thin septations but less internal complexity. Other possibilities include endometriomas, paraovarian cysts, cystic teratomas, and borderline ovarian tumors, though these often exhibit different characteristics such as internal vascularity or specific echogenic features.

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The prognosis for hemorrhagic ovarian cysts is generally excellent, with most resolving spontaneously within one or two menstrual cycles. Follow-up imaging is recommended to confirm resolution.